142nd APHA Annual Meeting and Exposition

Home Events & Meetings Annual Meeting Schedule & Program

Online Program

Annual Meeting Recordings are now available for purchase

311027
Event-level analysis of factors associated with condom use during coitus among female sex workers

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Alexis Roth, PhD, MPH , University of California San Diego, La Jolla, CA
Devon Hensel, PhD , Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN
Sarah Wiehe, MD MPH , Indiana University School of Medicine, Indianapolis, IN
J. Dennis Fortenberry, MD, MS , Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
Karla D. Wagner, PhD , Division of Global Public Health, University of California San Diego, San Diego, CA
Background:  Understanding the factors associated with condom use during coital events, among female sex workers (FSWs), has important implications for intervention design.

Methods: Longitudinal study of 26 (mean age=43.1) FSWs who completed twice-daily electronic diaries via cell phones over 4-weeks. Diaries recorded the number of coital events and event-level factors at each event (e.g., partner type, venue, other sexual acts, motivation for the sexual event). To model the outcome of interest (condom use during each coital event [yes/no]), we used binary logistic generalized estimating equations, controlling for events nested within participants.

 Results: Participants reported 217 coital events, 46% of which were condom protected. In univariate analysis, events motivated by a desire to obtain money were associated with increased odds of condom use (p < .01) though being paid was not. Coital events that involved kissing (p< .01), receptive oral sex (p< .01), or that were initiated by the FSW (p=.05) were associated with a decreased odds of condom use. In multivariable analysis, kissing (AOR=.11, 95%CI=.30-.37), receptive oral sex (AOR=.31, 95%CI=.09-1.01), and a desire to obtain money (AOR=4.87, 95%CI=2.89-8.21) were independently associated with condom use.

Conclusions: FSWs’ decisions about whether or not to use condoms are informed by a set of social, emotional, and economic factors that vary across sexual events. The dynamic nature of condom use requires analytic approaches and interventions that are sensitive to event-level variations. It is critical to acknowledge that an FSW is just one of two actors in condom negotiations, thus larger trials and dyadic studies are needed.

Learning Areas:

Program planning

Learning Objectives:
Describe individual and event-level factors associated with condom use during vaginal sex among female sex workers.

Keyword(s): Behavioral Research, Sex Workers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted all of these analyses in conjunction with my co-authors and because I specialize in FSW health research
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 2070.0: Addressing the sexual and reproductive health needs of especially vulnerable populations